Intermittent explosive disorder ... Impulsive aggression is not premeditated, and is defined by a disproportionate reaction to any provocation, real or perceived.IntermittentexplosivedisorderFromWikipedia,thefreeencyclopediaJumptonavigationJumptosearchMedicalconditionIntermittentexplosivedisorderSpecialtyPsychiatryIntermittentexplosivedisorder(sometimesabbreviatedasIED)isabehavioraldisordercharacterizedbyexplosiveoutburstsofangerand/orviolence,oftentothepointofrage,thataredisproportionatetothesituationathand(e.g.,impulsiveshouting,screamingorexcessivereprimandingtriggeredbyrelativelyinconsequentialevents).Impulsiveaggressionisnotpremeditated,andisdefinedbyadisproportionatereactiontoanyprovocation,realorperceived.Someindividualshavereportedaffectivechangespriortoanoutburst,suchastension,moodchanges,energychanges,etc.[1]ThedisorderiscurrentlycategorizedintheDiagnosticandStatisticalManualofMentalDisorders(DSM-5)underthe"Disruptive,Impulse-Control,andConductDisorders"category.Thedisorderitselfisnoteasilycharacterizedandoftenexhibitscomorbiditywithothermooddisorders,particularlybipolardisorder.[2]IndividualsdiagnosedwithIEDreporttheiroutburstsasbeingbrief(lastinglessthananhour),withavarietyofbodilysymptoms(sweating,stuttering,chesttightness,twitching,palpitations)reportedbyathirdofonesample.[3]Aggressiveactsarefrequentlyreportedaccompaniedbyasensationofreliefandinsomecasespleasure,butoftenfollowedbylaterremorse.Contents1Pathophysiology2Diagnosis2.1DSM-5diagnosis2.2DSM-IVdiagnosis2.3Differentialdiagnosis3Treatment4Epidemiology5History6Seealso7References8ExternallinksPathophysiology[edit]Impulsivebehavior,andespeciallyimpulsiveviolencepredisposition,havebeencorrelatedtoalowbrainserotoninturnoverrate,indicatedbyalowconcentrationof5-hydroxyindoleaceticacid(5-HIAA)inthecerebrospinalfluid(CSF).Thissubstrateappearstoactonthesuprachiasmaticnucleusinthehypothalamus,whichisthetargetforserotonergicoutputfromthedorsalandmedianraphenucleiplayingaroleinmaintainingthecircadianrhythmand